Wednesday, April 16, 2008

Statute of Limitations?

We finished the last of our five unsuccessful rounds of IVF with our local clinic almost three years ago in May of 2005. That's not counting the two IUIs we did before my RE convinced me I was such a "high responder" that it made more sense to move to IVF and not waste time on IUI. Five. Unsuccessful. Two of those with PGD that showed horribly messed up embryos (we're talking five of one chromosome, none of another, etc.) After which my RE told me the chances of me having a biological child with my own eggs was like "finding a needle in a haystack." And then proceeded to tell me that the Big Clinic we planned to go to for a second opinion (just to put our minds at rest that we did everything possible) would never accept us because I was too much of a "risk factor" to their statistics, given my horrible track record (Five. Unsuccessful. Remember?)

After we had success at Big Clinic, I tried not to dwell on the fact that we "wasted" SO much money at the local clinic before we went to Big Clinic. I justified it by telling myself that without the benefit of the hindsight of those five cycles, my RE at Big Clinic might not have been able to come up with the exact right protocol on the first shot. But it still made me shudder when I added up, mentally (and on our tax returns for purposes of medical expense deductions) how much we had spent. We were lucky enough to have some insurance coverage- 50% for most cycles- but with PGD and ICSI (not covered by insurance) we were easily out upwards of $50,000.

Last week in the mail I received a bill for $2,000 for a cycle from MARCH 2005. It's now April 2008. Trying to decipher the transactions on the bill, all I could make out was that even though the original charges were incurred in 3/05, something didn't happen with our insurance (an "adjustment"-- I am guessing that is their deduction for the agreed-upon price the clinic can charge according to my insurance company?) until March of this year.

My first reaction was rage. How can they send us a bill for a cycle from THREE YEARS AGO when we had checked numerous times after we left the clinic to make sure we had paid everything that was due? Luckily, I am pretty anally organized and had the paperwork on hand from that cycle, including an itemized statement showing that we paid a 50% co-pay of $3250 in addition to $5000 for PGD and $2000 for ICSI. Just looking at that statement- and all of the other statements in that pile of paperwork- made me want to throw up. If we had just a fraction of that money back today, it would seem like a fortune. At the time, I was working in a well-paid job and we could afford it, but now that I'm at home with the kids, money like that seems like an outrageous amount.

So of course I then spent the next several days gathering information, trying to get answers from the billing office, my clinic, and the insurance company. Each pointed to the other one-- "we don't know why you owe that amount-- check with [your insurance company, the billing office, the IVF clinic]." And it didn't help that the billing manager at the clinic ignored my phone calls until I sent an email, which I copied myself on in case I had to go to the doctor, which was my next step. She must have felt a little more accountable for a request that was in writing vs. my voice mails (no documentation) because she got back to me PDQ after I sent the first email.

From what I can tell (and this whole thing is so complicated and convoluted I really don't know which way is up any longer), they are claiming that the 50% co-pay the clinic charged us at the outset was not enough to cover the costs not covered by insurance, and that they did not get the final word from our insurance as to what it would cover until last month due to a lot of back-and-forth getting billing codes correct, etc. This is despite the fact that the policy of the clinic was to collect the full co-payment up front (after verifying with insurance how much I would owe) before the cycle. And despite the fact that we paid $10,250 for the cycle anyway. (OK, that makes me want to gag again. That was for ONE of our SIX cycles).

If anyone out there knows anything about medical billing and insurance reimbursement, do you have any insight into this? My response in the end was to mail the billing office a copy of the statement from our cycle- which showed that we paid the $3250 co-pay which was supposed to cover, among other things, the two services they are now billing for (retrieval and culture/fertilization) and requested a full explanation of why that co-pay did not cover what they are billing us for now and why it has taken three years for this charge to come to light. I want to put the burden on their shoulders to unravel this complicated web of insurance and medical charges because despite the fact I am an intelligent person (I'm actually an attorney- go figure...) I have NO idea why we're being charged for this now, or even if they can bring this up three years after the service. I have a sick feeling we're going to end up having to pay this in the end- to a clinic that basically kicked us out to the curb- but I'll fight it tooth and nail before we do.

Monday, April 14, 2008

Adjustments

One thing I really wanted to know before Smiley arrived was what the addition of a new baby to our family would mean in terms of our day-to-day life and logistical reality. So in case anyone is reading this blog who is expecting a third very soon after their twins (or even expecting their second child soon after their first), here are the major adjustments we've had to adapt to and issues we've faced over the last several months:



Zone Defense vs. Man-to-Man: This is probably the single biggest adjustment. With two kids, I was easily able to transport and supervise them myself. When we went out as a family to gatherings, like neighborhood barbecues or birthday parties, generally DH or myself could keep an eye on the kids while the other one hung out with friends, grabbed something to eat and otherwise relaxed. Now outings look something like this: I take care of Smiley, holding her and/or feeding her if she is not sleeping in her carseat, which barely happens any longer now that she's almost six months old. DH keeps an eye on the twins, getting their food and drink, making sure they don't try to pull things down from a counter or eat something they shouldn't, changing poopy diapers, etc. So neither of us really gets a chance to just relax. I've seen DH step up a LOT more now because of this. Before, it was generally me doing all the work with the twins while he got involved in a conversation with a friend or grabbed a bite to eat. Now he's on full duty with either Smiley or the twins. However, it is getting easier as the twins get older and they're able to go off on their own and play. We actually let them go down in a basement playroom at a neighbors' house to play with the "big kids" on their own recently. I was going down every two seconds to check on them to make sure they were OK, but I think it's the start of them getting more independent, freeing us up to take turns with the baby. In fact, we left Smiley with her grandparents this weekend while we took the twins to a birthday party and as the twins played off on their own with their friends, I mentioned to DH that I was actually bored without Smiley to take care of!



Out and About: When I'm out and about on my own, it's a little trickier to transport three kids, especially when one is an infant. At first I was doing a lot of double stroller/baby bjorn combinations but that was waking Smiley up and let's just say Smiley wasn't so Smiley when it was time to put her back in the carseat. So we ended up buying this "freak show" of a stroller which allows me to put Smiley, in her carseat, into the stroller, while one twin sits in the other seat and the other stands on the back. You should see the looks we get when we use this stroller. I really like it despite the fact it's huge. I don't use it all that often because for short walks the twins can walk or I can take the double stroller, put Smiley in one side, a twin in the other, and have the second twin hold my hand while we walk; but for shopping trips when I just need to get everyone in and out quickly or for longer commutes, this stroller is worth it's weight in gold.



Different Ages, Different Stages: I honestly think that it is probably easier to have triplets than to have twins and a newborn, just because of the different needs of the two different age groups. Whereas the twins want me to sit down with them and read a book, wait while they sit on the potty (but of course not actually "go") or play with them outside, Smiley needs to have a bottle, take a nap, etc. If all three needed the same type of attention, it wouldn't be as difficult as giving the two age groups (toddler and infant) different types of attention. There is a sort of economies of scale with multiples. So often I find myself feeling bad that Smiley is sitting in the Exersaucer while I read the twins a story or serve them their lunch, or when the twins are left to play by themselves while I give Smiley a bottle (speaking of which, I ended up nursing for one month and then pumping and bottle feeding-- mostly because of time and efficiency issues-- until she was 4.5 months old). It's times like this that I am actually thankful I have TWO older kids, though, as at least they have a friend to play with while I am busy with the baby. I also realize I'd have these issues no matter if I had just one older child or two...it's simply an issue of different needs for different types of attention.



Scheduling: With a newborn/infant, scheduling is always tricky. Try synching that with the schedules of older twins. Luckily, for now at least, I think I've done a good job of coordinating Smiley's second nap of the day with the twins' one big nap of the day, typically (but not always) giving me one long stretch of time in the afternoon when all three kids are sleeping and I can get things done. But occasionally Smiley will wake up from her morning nap just in time for the twins to go down for their long nap. And you guessed it-- they are waking up from their nap just about the time she's going down for her second nap. I've figured out that if I keep Smiley awake by keeping her out and about in the mornings (which generally isn't difficult since we're always running around with the twins to their activities) I can usually sync their naps in the afternoon. Plus, I try to tweak her feeding schedule to fit into the twins' schedules. Usually it works, but it definitely takes some thought and coordination.



In general, though, now that we've gotten into a routine, things go pretty smoothly and it's fun having a baby around and watching the twins dote on their sister. I can tell already that the three of them are going to be VERY close, and it makes all of the work well worthwhile.

Sunday, April 13, 2008

Re-Inspired

OK, OK...I know it's been a very long time since my last post. And no, I really can't use the excuse of having three little ones for my utter lack of posting. First of all, ironically I no longer technically have "three under two," as our twins turned two years old at the end of March (!!!) Second of all, we've settled into a nice routine now that LS is 5 1/2 months old. Since she was about 4 months old, I've had my evenings back and can count on a pretty good night's sleep, as she goes down right before the twins around 7:00 and generally doesn't get up until somewhere between 5 and 7 a.m. I can't complain. I've had plenty of time to get back to my volunteer activities, train for my upcoming marathon and lurk on everyones' blogs...so I have been keeping up with everyone else and always feel guilty for neglecting my own blog! It's just that I had let so much time slip by it seemed kind of silly to pop back in and start posting again.

But today I met up with the Order of the Plastic Uterus, an AMAZING group of women. Even though I only knew one of the members in attendance in real life (the utterly inspirational and tireless Mel), I really felt like I had known everyone else for a lifetime. Maybe it's our shared experiences or maybe it's the fact that I've been following their blogs through Mel's blogroll (and LJ's blogroll of the members of the Order) but I left feeling like I had just caught up with a bunch of old friends. I also left feeling like it was unfair that all of these ladies had allowed me an intimate look into their lives through their blogs, but I didn't reciprocate by keeping up a blog of my own. Not that everyone (or anyone for that matter) should necessarily find my life captivatingly interesting, but it only seems fair that if I get to look into their lives, they should have the opportunity to look into mine. Same goes for all of the other bloggers with blogs I read all the time.

So I am making a resolution to start posting more regularly again now that we've settled into a nice groove as a family of five. Don't get me wrong- there was plenty of adjustment going on the first few months (which I'll be sure to blog about in the future). But now it feels like we always had three kids and I'm really enjoying watching LS (who, by the way, I think I'll start calling Smiley because that is much more fitting than LS, since this baby smiles almost ALL of the time) go through the stages that are sort of a blur for the twins.

Before I sign off today, I just have to add that I'm feeling extremely self-conscious after I got home from our gathering today and our older daughter, now just barely two years old, points at my (admittedly bloated from too many brownies and cheesecake) tummy and says "Baby?!!" DH did his best to hold back his laughter as I didn't know whether to laugh or cry. No, sweetie-- no baby, just what Mommy's tummy looks like after having three babies in the course of 19 months. You can thank me later.

Friday, November 16, 2007

Second Time Around

Now that we've had a few days (two weeks to be exact) to settle in to our new "normal," I've been reflecting quite a bit on how different things are this time around. Talking to my friends who have more than one child (most who never struggled with infertility, granted), it seems like we all share the sense that things are much easier- and more relaxed- the second time around.

A friend of mine who has twin girls that just turned one is thinking of having a third and asked me if it's much easier with one. I told her that it is much easier, but I'm not sure if it's a function of having "just one" or if it is because I'm no longer a first time mother.

With the twins, everything seemed overwhelming at first, in particular my attempts to nurse them. I will never forget the endless days and nights where I felt like I did nothing but try to nurse one, then supplement that one with formula, then try to nurse the other and supplement that one with formula, THEN pump to try to get breast milk to feed by bottle later. By the time that whole cycle was done, it was time to feed again. Even though I gave up nursing after about a week at home, I kept up the pumping and pumped 7-8 times a day after feeding both babies. Not only was it time consuming, but I felt like such a failure for not being able to do what my body should do naturally. My mother-in-law is a pediatrician, so the pressure from her (subtle, but definitely there!) was unbearable. DH was wonderfully understanding, telling me to do whatever made me the happiest, but I still couldn't accept the fact that I had failed- yet again- at something I should be able to do.

This time around I decided to give nursing a try while I was in the hospital, but had pretty much resigned myself to formula feeding once we got home. In fact, I felt sort of proud of the fact that I wasn't going to let myself feel sorry for not nursing this time. I pictured myself telling my mother-in-law and the lactation consultants at the hospital, "Thanks for your advice, but we have chosen the best option for ourselves and our family, and it is a personal decision I hope you will respect." After all, I definitely don't feel that feeding a baby formula, even exclusively, is harmful. While breast milk may be "best" by certain standards, I really think that genetics and family health history also play a much more significant role in the health and development of a child. I always say that I was formula fed and DH was breast fed (albeit for only a few months, which I didn't find out until way after I felt guilty for letting my MIL down...) and I have far fewer health problems and allergies than DH does. So I'm a shining example that formula-fed babies don't have to be less healthy than those who are breast fed :)

So imagine my surprise when LS actually gained weight in the hospital before we left, and the pediatrician at the hospital told me that he hardly ever sees that happen, that nursing must be working really well for us. And imagine my further surprise at LS's two week pediatrician appointment yesterday when we found out she not only surpassed her birth weight but passed it significantly. Whereas babies should be gaining an ounce a day at this point, she gained two ounces a day. And she hasn't had a bottle yet- I've been nursing exclusively (now there are two words I never thought I'd use in a sentence when talking about me and one of my children).

I think a big part of our success this time is that I am much more laid-back than the first time around. Having the attitude that at any time I can stop and switch to formula if necessary, and that I won't be a failure because of it, really took the pressure off. I'm also not so worried that my baby will waste away if nursing doesn't work...I realized that if she was losing weight, I'd just simply supplement with formula and all would be well. With the twins, I got freaked out that they were losing too much weight- in part because the nurses at the hospital made me freak out- and immediately doubted my ability to nourish them with my own body. Of course, it doesn't hurt that this time around there was "just one" to feed, whereas last time there were two!

So I think that my whole experience with nursing mirrors my entire approach to parenting this time around- more laid-back, recognizing that there is no "right" or "wrong" way of doing things. It's OK if the baby cries for a few minutes while I get the twins settled in with their breakfast or snack. It's OK if I can't spend every moment doing productive activities with her in an effort to make sure her little brain develops correctly. It's OK if I take a few minutes for myself. I don't think that any of this has to do with having "just one" this time- although the extra sleep at night does help!- but I do think that it's a factor of having the perspective, and hindsight, that comes the second time around.

Saturday, November 10, 2007

Birth Story, Part 2

LS is napping now, but the twins are due to be up any second...let's see how much more of the birth story I can get down before they're awake.


So the first spinal didn't take. My doctor wisely advised me that as horrible as it sounded (and as I indicated by the tears rolling down my face as I realized the first one hadn't taken), it would be "better in the long run" if we "got it right" with a second try. I fully agreed- the last thing I wanted to do was feel anything related to the actual cutting! My hot-shot anaesthesiologist called in his colleague, who was scheduled to attend the next c-section, to give it a shot (no pun intended). In the meantime, he had tried again, which involved about 10 more shots of the topical numbing medication and at least two tries with the big needle going into my spine. All the while, I'm holding on to one of the nurses (I think she was a nurse) for dear life, shaking uncontrollably, either from fear or the large amount of anaesthesia I already had injected.

After what seemed like forever (turned out to be about 45 minutes after the ordeal started), the second doctor got the shot in the right spot and I was laid back down to let it take effect, hopefully. Luckily, when they tested me again I couldn't feel a thing. And from there on out, things went smoothly- and quickly. I did have a bit of nausea but the (new) anaesthesiologist put something in my IV that helped within a few minutes. DH was allowed back into the room as the surgical team prepared to cut, and within five minutes the doctor told DH to get his camera ready for the first shot of his daughter.

A few things I feel I should mention about the surgery itself- first, unlike the twins' birth (which was at a different hospital), DH was allowed to watch, and take still pictures, of anything he felt like watching. With the twins, he had to wait until the babies were born and then he could only take pictures of them- not of anything "behind the magic curtain" (i.e., my blood and guts). So whereas our first pictures of the twins are in an isolette as they were cleaned off, our first picture of this baby is her head emerging from the incision in my stomach. I'd share, but I'm not quite sure how many people want to see that image. The next shot is my first view of LS- and again, unlike the hospital where the twins were born, when I wasn't even able to see the twins until after they were checked out and cleaned up (in fact, my first image of them was not live but on the digital camera after DH took pictures of them and came back to show me as I was being stitched up), this time our wonderful doctor held LS up above the curtain so I could see her.

A second memorable fact about the surgery was that the doctors were all remarking about how little fat I have. I definitely don't mean to brag (and trust me- my stomach muscles and skin are so out of shape it doesn't really matter that I have little fat under it) but it was sort of gratifying, in a sick and twisted way, to hear someone actually looking at my insides that I have little fat, at least in my belly area.

Another interesting fact was how many people there were in the OR with me- I think DH counted at least 12 at one point, including my doctor, the anaesthesiologist, a neonatologist (a surprise since LS was term), and a host of nurses. I was surprised that there were so many people at a "normal" birth- I had expected it with the twins, but certainly not this time.

We had not found out the gender of this baby during my pregnancy, but as I've mentioned before, I felt strongly it was a boy. My official guess was a boy, 7 lbs. 2 oz. Well, so much for motherly instinct: obviously, it was a girl, and she was 7 lbs. 12.7 ounces. For the record, DH guessed girl, 7 lbs. 12 oz, so chalk one up for him!

Another surprise was the fact that LS has a full head of dark hair, unlike our twins who had very little hair and what they did have was light. I still remember the doctor saying, when he saw LS's head (but nothing else yet), "I'm not sure if it's a girl or a boy, but whatever it is has a head of dark hair!" My first reaction was "is he talking to me?" It's still a shock to see one of our children with dark hair, especially because DH is extremely fair and I was born with light hair. However, if anything, LS looks more like me than DH, which again is a surprise because our twins look so much like him. It also made me feel proud and particularly attached to LS right away, as I feel like I finally have a child who looks like me. And even though I didn't think I'd cry when LS was born, I bawled plenty of tears when I heard her cry and saw her face for the first time. For all my thinking it was a boy, and for all my worries about being able to love three children equally, there was no doubt that the moment I heard her voice, I was in total love with our new daughter.

As LS was weighed and cleaned, I was stitched up in what seemed like just a few minutes (I think it was more like a half hour, though). DH brought LS over to my side so that I could see her, and I remember one of the nurses telling me it was OK to touch her so I guess I was hesitant, or maybe feeling too constricted in the position I was in for surgery, to reach out to her. I just remember marveling at how surreal it felt to finally meet the little person who was inside me for so long, how we finally had a face (and a gender!) to put with the movements. I had said several times the night before and the morning of the surgery how I just couldn't picture how our family would look a few hours later- would we have two boys and a girl or two girls and a boy, and what would this baby look like? Now I had my answers, and everything seemed to fall into place.

After I was wheeled out of the OR, I was taken to a recovery area where I was told I'd stay for a couple of hours. I had some bad bouts of nausea, which were effectively treated with some meds in my IV. A nurse came in shortly thereafter to take LS for her first bath and to be checked out by the neonatologist. The neonatologist determined that LS was breathing rapidly, likely because of the fluid still in her lungs because she was born by c-section. She explained that they would monitor her for the few hours I was in recovery and if she did not improve by the time I was transferred to my room, she would go to the short-term (4 hour) NICU, and if she still didn't improve after that 4-hour stay, she would go to the NICU. I felt my first wave of panic- again, while I expected these sorts of issues to come up with the twins (none ever did, thankfully), I never expected them to come up with a full-term singleton.

Luckily, LS's breathing slowed down enough for her to go to my room with me when I was finally transferred. It was still rapid- in the 70's whereas normal range is 30-60, but over the next few hours it slowly came down to the 60's and then into the 40's. The only other issue the neonatologist spotted was some clicking in her hips, another issue that would seem to resolve itself by the time we left the hospital.

Our visitors arrived later in the afternoon, with my father coming first, followed by my sister and her husband, and then my father-in-law (our mothers were with the twins). I most anticipated having the twins come visit- I missed them a lot and just wanted to see their faces. After what seemed like forever (they had to take a nap and then eat lunch before leaving for the hospital), they finally arrived with our mothers and two "It's a Girl" balloons that they told me were for the baby. We spent the afternoon with our families, with me drifting in and out of sleep and and having a couple of episodes of nausea/vomiting from the anaesthesia.

Because of her rapid heartrate, the doctors and nurses asked me to hold off on trying to nurse LS until much later in the day. I was already apprehensive about trying to nurse- it wasn't quite smooth sailing with the twins (in fact, it was the most frustrating issue of the entire first few weeks of their existence) so I had already resigned myself to bottle feeding this new baby. Much to my surprise, however, she took to nursing pretty easily and although she lost weight at first, she actually gained a few ounces before we left the hospital. I have been taking it day by day, telling myself I can always go to formula if necessary, but so far I haven't even given her a bottle of expressed breast milk (ok, once I gave her a few sips just to see if she'd take a bottle). This has come as a complete surprise to me, as I really never expected to nurse this baby. We'll see how things go once DH goes back to work and I'm on my own with the twins, but for now I'm content with nursing and feeling rather confident that it's worked so well so far. After such a horrible experience with the twins, I've been pleasantly surprised to see myself able to make it work this time.

There are many other differences between the early days of LS's life and that of the twins (or at least my memory of it), but that post will have to wait for another day. For now I'm going to take advantage of the few hours of quiet I hope to have as the twins nap and LS sleeps after her last feed.

Thursday, November 8, 2007

Birth Story- Part 1

I only realized during LS's birth how much of the twins' birth story I had forgotten, so before any more time goes by (and while DH has the twins at their once-weekly Mommy- or Daddy- and Me nursery school program and LS sleeps), I want to get down as much of LS's birth story as I can remember.



The night before the birth was, of course, Halloween, my most loved and anticipated holiday. We spent much of the day as a family- DH came home early from work and we took the twins out to run some last minute errands as well as to a local Halloween festival for kids. On the way home, we picked up pizza for the four of us and my parents, who came by at dinner time to see the kids off and hand out candy while we trick-or-treated. We schlepped the kids out around our neighborhood, which gets VERY into the Halloween spirit. Our duaghter lapped it all up- she immediately got the hang of asking for candy (and saying thank you!) at every house, and laughed at even the scariest of decorations and costumes. Our son, on the other hand, already the more sensitive of the two kids, was a bit more skeptical. He was OK until the kid with the three-headed costume came out of a house, and then he clung to me like super glue. Needless to say, I probably carried more toddler than I should have, for longer than I should have. By the time we got home I had excruciating pain in my round ligament/groin area. Nothing I thought was labor (it was more muscular than contraction-like) but it made me realize that going into labor at that point would have actually been a good thing. First of all, I had been off of my blood thinner (in anticipation of the next morning's surgery) for the required 24 hours; secondly, if I went into labor, I could avoid a c-section.



In the end, it didn't matter because I was NOT in labor, just a lot of discomfort, which prevented me from sleeping a lot of the night. I fell asleep at about 11:00 p.m. and woke up at 3:00, unable (for a number of reasons) to fall back to sleep. I thought a lot that night and early morning about how much our lives were about to change, and was emotional at the thought of leaving our twins while I was in the hospital. Finally, at 3:30 I got up and showered to get ready for the day. We had planned to wake up at 4:30, anyway, so I was just about an hour ahead of schedule.



DH's mom arrived at our house at 5:15 in the morning (because my own parents, who live just a mile away, refuse to do anything before 8:30 or 9:00 a.m., but that's a whole different story...) She took some pictures- one of me as my "last picture before delivering" (she took the same picture before I delivered the twins) and one with me and DH. Looking at those pictures I realized how much smaller I really WAS (even if it didn't feel that way) then with the twins. After some last minute instructions, it was off to the hospital. I was sad leaving before I could say good morning to the twins, but also didn't want to risk waking them by going into their rooms before we left.



We arrived at the hospital about 15 minutes ahead of schedule at 6:00 a.m. There was no one at the admissions desk at the L&D unit, which made me wonder- what if someone had come in in active labor? We waited for at least 20 minutes before anyone came out to discover me waiting (DH had gone to the bathroom, of course, right as someone finally came out). I was admitted quickly and met my prep nurse, Paulette, who took me back to the pre-op preparation room before DH even came out of the restroom (he caught up to us while I was changing into my robe in the bathroom). Pre-op seemed to go by quickly- before I knew it, it was 7:00, just 45 minutes before my scheduled c-section. We went through all of the standard admission questions, which I seem to remember from the twins' birth. A few memorable interactions happened during pre-op: a nurse questioned Paulette's entry of "P2 G3" in the computer, indicating it was my second pregnancy but third child. Paulette explained (as did everyone else during my hospital stay any time they said "P2 G3") that I had twins at home...and of course added, for emphasis, that they were just 19 months old. This small fact seemed to make me a superstar at the hospital.



Another interesting incident that happened during pre-op was the fact that we had several "observers." The first was a student nurse who I would come to know well during my stay, and I didn't mind having her observe at all. In fact, I was her first c-section and she kept thanking me for letting her be a part of such an important part of our lives. The second, though, was a (seemingly) random guy who came into the pre-op room in scrubs. I think he got off on the wrong foot with me with one of his first questions- when he heard I had twins at home, and that they were boy/girl twins, he asked me if they were identical or fraternal. One of my pet peeve questions- when someone asks me that question, their perceived level of intelligence in my head goes WAY down. Now maybe that's unfair- if I didn't have boy/girl twins, maybe I'd fail to understand that to be identical, twins must be identical in ALL OF THEIR PARTS too, but I really didn't like this guy from the get-go. It turns out he was from the local fire department, where they send trainees to the hospital to watch operations so that they get used to seeing blood and guts. Now I'm all for supporting our local fire department, but I really didn't see the need for this guy (who was already making stupid comments) to watch MY blood and guts along with the 12+ other people who would be in the operating room. When Paulette asked me (in private) if I minded having him observe, I told her he could observe the pre-op procedures but that I would prefer he didn't come into the operating room. I felt a little badly, but it was also my prerogative to limit the number of "observers" in the OR, and if anything went wrong I wanted fewer people in the way.



While in the pre-op room, my doctor came to talk to me along with the anaesthesiologist. I really do love my doctor- this isn't' the one I had planned to have do my c-section, but he's one of my favorites in the practice anyway and just a really great guy. After the necessary preparations were taken, including inserting my IV (one of my biggest fears but Paulette did a great job) and shaving "down there," I was walked into the OR next door. The anaesthesiologist prepped me for my spinal, which unbeknown st to me at the time would become the most trying experience of my entire delivery.



To start out with, the idea of a needle going into my spine is NOT my idea of fun. However, when I had my c-section with the twins, it was a relatively easy and unpainful process. That time, however, I had an epidural with a spinal IN the epidural (in other words, a tube in my back that fed both the epidural meds and the spinal meds into my back). That was a different hospital, though, with different protocols, and at this hospital the protocol for c-sections is a spinal only, which means a shot into the spinal fluid (no tube inserted). I knew there was trouble when the anaesthesiologist seemed to have to try several times to get the needle in the right spot. Luckily this was after he had given me a few shots of local anaesthesia so I didn't feel it that much, but I was still uncomfortable. Finally, after what seemed like forever, he thought he got the meds in the right spot (and in fact told me that with spinals, you know for sure because some of the spinal fluid comes back in the syringe- nice image, thanks). However, when I laid down and was tested several minutes later for numbness, it was obvious the spinal had not taken.



LS is fussing...the rest of this story is going to have to wait until later...guess this is the story of my life from now on :)

Sunday, November 4, 2007

Quick Update

Just a quick update- first of all, thanks to Mel for the shout-out in her Friday Blog Round-Up. I feel like a celeb for even being mentioned :)

So we now have answers to a lot of the questions I had in my last post: first of all, it was a girl, a beautiful, 7 lb. 12.7 oz. girl who I'll call "Little Sister" (or LS) for purposes of this blog, at least until I come up with a more apt nickname. Unlike her older siblings, LS has a full head of dark hair, which was quite a shock. So far, she's amazingly easy- but then again, I think all babies are pretty easy at this stage (eat, sleep, excrete, repeat...)

The birth itself was pretty smooth and uncomplicated, except for the little issue of the spinal, which took one hour, two tries, and a second doctor to complete...not something I ever want to repeat in my life. However, the recovery so far has been much easier than I remember it being with the twins. I'll post the full birth story when I get a few minutes to reflect- hopefully sooner rather than later as I don't want to forget the small details like I seem to have done with our twins birth!

The hospital stay was wonderful- I really enjoyed bonding with LS and even though I missed our twins sorely, they did come to visit and I could still appreciate having the time to myself (and LS) at the hospital.

Most surprising, I am nursing LS exclusively so far and doing well, if I may say so myself. Nursing was my nightmare issue with the twins- by far the one issue that made me most miserable- so I am shocked (pleasantly) at the ability to do this- successfully it seems- so far. She lost a little weight the first two days in the hospital (nothing to be alarmed about, though) and then GAINED the last day we were there. Even the pediatrician said that was not routine, and must mean that she's thriving on my breast milk. I still have to stifle a laugh when I hear people say things like that- I can't believe they are talking to me. I'm taking it a day at a time- I know things can change, especially now that I'm home and real life (vs. life in the hospital, with all the time in the world) kicks in. But for now we're making it work, me and little LS.

The twins have been such troupers and seem to love their LS already. I'm SO proud of them. My heart was so filled with pride, love and joy tonight when we got home and the five of us were sitting around, enjoying life as a new family, that I almost started crying. What a different experience from when we got home from the hospital with the twins and my crying was more out of frustration and a feeling of ineptitude. Again, I know there will be frustrating times ahead, but for now I'm just basking in this beautiful feeling and appreciating the many blessings we've been given.